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EMERGENCE AND CLEARANCE OF GAMETOCYTES IN UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA

We reviewed the records of 1,175 patients with uncomplicated Plasmodium falciparum malaria to determine the prevalence of gametocytemia. All patients were admitted and received artemisinin combination therapy. Blood films were checked daily until discharge. Circulating gametocytes were observed in 240 (20.2%) of patients and in most cases (222 of 240, 92.5%) gametocytemia was detected during the first 24 hours after admission. Gametocytes were first seen in 174 cases on admission, in 24 cases at 12 hours, and in 24 cases at 24 hours. The longest interval between admission and first appearance of gametocytes was 192 hours. The median gametocyte clearance time was 163 hours (range = 12–806) in the 219 patients in whom gametocytemia resolved. However, 21 patients (9.8%) still had gametocytemia on discharge. Gametocytemia generally is present within the first 24 hours after admission, and emerges in only 1.9% of patients later on during treatment with artemisinin.

Received October 10, 2005. Accepted for publication October 28, 2005.

Acknowledgments: We thank Dr. George Watt (Faculty of Tropical Medicine Consultant) for helping to review the manuscript and Dr. Wirongrong Chierakul for statistical advice. We also thank the staff of the Hospital for Tropical Diseases for their help and support.

^* Address correspondence to Watcharapong Piyaphanee, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand. E-mail: tewpe{at}mahidol.ac.th

Authors’ addresses: Watcharapong Piyaphanee, Noppadon Tangpukdee, Wipa Thanachartwet, Udomsak Silachamroon, Nantaporn Phophak, Chatnapra Duangdee, Orathai Haoharan, Suparat Faithong, Polrat Wilairatana, Wattana Leowattana, and Sornchai Looareesuwan, Department of Clinical Tropical Medicine and Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand, Telephone: 66-2-354-9100, Fax: 66-2-643-5578, E-mails: tewpe{at}mahidol.ac.th, tmntp{at}mahidol.ac.th, tmvtn{at}mahidol.ac.th, tmusl{at}mahidol.ac.th, tmpwl{at}mahidol.ac.th, dirctm{at}mahidol.ac.th, and tmsh{at}mahidol.ac.th. Srivicha Krudsood, Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand, E-mail: tmsks{at}mahidol.ac.th.

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